Viscosupplementation is an injection treatment that has been approved by the U.S. Food and Drug Administration (FDA) for use in relieving discomfort associated with knee arthritis. Viscosupplements are often referred to as “rooster comb” injections, mainly because this treatment is sometimes derived from avian sources – specifically, sterilized rooster combs (the fleshy crown on the top of a rooster’s head).

Usually, viscosupplementation is considered as a second- or third-line treatment after weight loss, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and other conservative remedies do not provide sufficient symptom relief. For instance, an injection treatment may be helpful to a patient who has moderate osteoarthritis, occasional symptom flare-ups, or knee pain that was triggered by a fall or other trauma.

How does viscosupplementation work?

A healthy knee contains synovial fluid, a natural lubricant that reduces friction, cushions the joint, and helps the bones within it glide smoothly together during movement. Synovial fluid contains hyaluronic acid, a thick substance that can gradually break down and become less concentrated over time due to arthritic changes in the knee. A low level of knee lubricant can allow the bones in the joint to grind against each other, causing pain and stiffness that eventually limit the range of motion.

A viscosupplement involves the injection of a small amount of hyaluronic acid directly into the joint capsule of an arthritic knee. The goal of an injection treatment is to artificially supplement the joint fluid’s natural viscosity, which can temporarily:

Increase joint range of motion

Reduce discomfort

Improve mobility

Slow the progression of pain from arthritic degeneration (there is no cure for osteoarthritis)

What happens after an injection treatment?

Following an injection of hyaluronic acid, many patients begin a rehabilitation program that includes gentle, progressive knee exercises. Physical therapy can enhance the effects of viscosupplementation, further improve joint range of motion, and strengthen the muscles that support the knee.

If you’re interested in trying an injection treatment for knee osteoarthritis, you are encouraged to consult with Peter D. Vizzi, MD, in Lafayette, LA. A board-certified orthopedic surgeon who offers both conservative and surgical treatment options for knee arthritis, Dr. Vizzi can develop a customized treatment plan to help you overcome your pain and other symptoms.